Chronic serous mastoiditis, idiopathic hemotympanum and cholesterol granuloma of the mastoid

Sheehy, James L.; Linthicum, Frederick H.; Greenfield, Elliott C.

doi:10.1288/00005537-196907000-00001

Cited by 48 publications

(18 citation statements)

References 7 publications

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“…From one point of view, idiopathic haemotympanum is not a speci c disease but 'a phase of otitis media with effusion'. 1,2 However, certain differences are noted when the independent disease, CG, is compared with intractable otitis media with effusion. Comparing special features of CG with those of intractable infant otitis media with effusion, Nakano 3 states that the incidence of CG is highly unilateral, commonly found within the range of 10-19 years of age, affected subjects have eustachian tube dysfunction, are affected by blue eardrums and the symptoms are intractable.…”

Section: Discussionmentioning

confidence: 99%

Surgical intervention in middle-ear cholesterol granuloma

et al. 2003

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Eleven patients who had been surgically treated from 1988 to 1999 were retrospectively reviewed in order to evaluate the ef cacy of ventilation tube insertion and mastoidectomy with, or without, mastoid obliteration for intractable middle-ear cholesterol granuloma. The mean age registered was 17.2 years at the time of surgical treatment. All cases were unilaterally affected. Five ears were treated with simple mastoidectomy coupled with the insertion of a ventilation tube, while six others had additional mastoid obliteration. The hearing prognosis was excellent with an improved post-operative hearing level of 16.5.dB (cf. pre-operative 37.7.dB). However, morphological prognosis revealed two ears had a residual perforated tympanic membrane without otorrhoea after displacement of the ventilation tube. Of the remaining nine ears with intact placement of the ventilation tube, ve had dry ears while four had occasional otorrhoea. Although the morphological prognosis was incomplete, treatments involving at least an insertion of a ventilation tube with thorough mastoidectomy were thought to be necessary.Key words: Granuloma, Foreign-Body; Middle Ear Ventilation; Mastoid, surgery Introduction Cholesterol granuloma (CG) is a pathological term that describes a lesion often observed during operative procedures for chronic middle-ear diseases. In cases where partial blockade of the middleear cavity is found, mucosal vasculature-derived transudation and cholesterol precipitation are encountered in obstructed peripheral air spaces. As a result of the ensuing foreign body reaction to cholesterol crystals, a granuloma is formed. In other words, middle-ear lesions such as chronic otitis media, adhesive otitis media and middle-ear cholesteatoma, etc., are often accompanied by CG. The existence of major CG in the form of otitis media without other middle-ear diseases causing blockade, however, has reinforced the concept that middle-ear CG is an independent disease per se. As a single disease, CG is intractable and its aetiological/ therapeutical perspectives remain unresolved. As CG prevails within the mastoid cavity, surgical intervention has been resorted to as a reliable con rmatory diagnosis of the lesion, despite recent advances in imaging diagnoses. In this study, clinical investigations focusing on surgically con rmed cases of CG as an independent disease were attempted to evaluate the ef cacy of surgical treatments for intractable middle-ear CG.

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Section: Discussionmentioning

confidence: 99%

Surgical intervention in middle-ear cholesterol granuloma

et al. 2003

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“…Cholesterol granuloma (CG) of the petrous apex arises due to an inflammatory reaction to the byproducts of eroded marrow cavities secondary to chronic obstruction of air cells within the petrous apex. 1 , 2) Various approaches have been used for the drainage and permanent aeration of the petrous apex, such as the transsphenoidal approach, middle fossa approach, and transpetrous approach, with the aim of preventing CG recurrence. However, the recurrence rate of petrous apex CG remains high, at up to 60%.…”

Section: Introductionmentioning

confidence: 99%

Petrous Apex Cholesterol Granuloma: Importance of Pedicled Nasoseptal Flap in Addition to Silicone T-tube for Prevention of Occlusion of Drainage Route in Transsphenoidal Approach—A Technical Note

Shibao

Toda

Tomita

et al. 2015

Neurol. Med. Chir.(Tokyo)

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Recently, petrous apex cholesterol granulomas (CGs) have been treated via the endoscopic endonasal transsphenoidal approach (EEA) using a silicone tube, to prevent drainage route occlusion. Occlusion of the drainage route has led to problems with recurrence. The aim of this report is to describe the use of a surgical technique to prevent drainage route occlusion. In surgical technique, the posterolateral wall of the sphenoid sinus was opened by EEA. After cyst debridement, a vascularized nasoseptal flap with a width of approximately 4 cm was inserted into the lumen with a silicone T-tube with a diameter of 7 mm. This technique was used in two patients: the first patient during the second operation after recurrence following occlusion of the drainage route, and the second patient during the first operation. Opening of the cyst wall was confirmed endoscopically in both patients 12–24 months after surgery, even after removal of the T-tube. In conclusion, the use of a pedicled nasoseptal flap with a silicone tube is useful to prevent CG recurrence, by paranasal cavitization of the cystic cavity.

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“…8 Yet despite numerous experimental studies and clinical and histopathologic observations, the pathogenesis of cholesterol granuloma remains uncertain. 1,9 We believe that it probably occurs as a result of several mechanisms. None of the aforementioned possible etiologies appears to apply to the mass in our patient.…”

Section: Discussionmentioning

confidence: 96%

Cholesterol Granuloma of the External Ear Canal: A Rare Presentation

Shu

Yang

2010

Ear Nose Throat J

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Almost all aural cholesterol granulomas develop in the mucosa of the middle ear. We describe the case of a 14-yearold girl who presented with an asymptomatic, nontender, dark-blue, cystic lesion in the posteroinferior portion of the left ear canal. The mass was excised via a postauricular approach. Postoperatively, the mass was identifi ed as a cholesterol granuloma on pathologic examination. To the best of our knowledge, this is the fi rst reported case of a human cholesterol granuloma limited to the external ear canal.

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Chronic serous mastoiditis, idiopathic hemotympanum and cholesterol granuloma of the mastoid

Cited by 48 publications

References 7 publications

Surgical intervention in middle-ear cholesterol granuloma

Surgical intervention in middle-ear cholesterol granuloma

Petrous Apex Cholesterol Granuloma: Importance of Pedicled Nasoseptal Flap in Addition to Silicone T-tube for Prevention of Occlusion of Drainage Route in Transsphenoidal Approach—A Technical Note

Cholesterol Granuloma of the External Ear Canal: A Rare Presentation

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